Rene Geronimo Favaloro
Argentinian physician Dr. Rene Favaloro (1923 - 2000) was a world-renowned heart surgeon who performed the first successful planned bypass surgery of the coronary artery in 1967 at the Cleveland Clinic in Ohio. He later taught his technique for grafting arteries.
Humble Beginnings
Rene Geronimo Favaloro was born on July 14, 1923, in La Plata, Argentina. His father, Juan B. Favaloro, was a carpenter. His mother, Ida Y. Raffaelli, was a dressmaker. Both of his parents were Sicilian immigrants. Favaloro was inspired to become a doctor by an uncle who was a physician.
Favaloro received his bachelor's degree in 1941 and served with the Argentine Army during World War II. In 1946, when Favaloro was discharged as a lieutenant, he began his medical studies at the University of La Plata. In 1949 he received his medical degree and then served an internship at Polyclinic Hospital in La Plata.
When a country surgeon in Jacinto Arauz, a very poor village 300 miles away from La Plata, fell ill and needed a few months away from his practice, Favaloro went to serve in his place. For the rest of his life Favaloro took to heart the lessons he learned in Jacinto Arauz. According to Eric Nagourney, writing Favaloro's obituary for the New York Times, the doctor had once said that all doctors in Latin America should be required to work among the poor. Favaloro had told the San Diego Union Tribune: "They would be able to see the combination of dirt and fumes. The people have only one room where they cook, they live, they make love, where they have their children, where they eat." His sojourn in the village also kept him focused all his life on advocating health care for everyone, no matter what their economic situation, and it inspired him to establish his Fundacion Favaloro in 1975.
Favaloro's brother, Juan Jose, also became a surgeon, and the two set up a medical practice in La Pampa. They had the only X-ray machine in a 150-kilometer radius. Favaloro spent the next 12 years taking postgraduate courses and performing general surgery at Rawson Hospital in Buenos Aires. Favaloro married his high school sweetheart, Maria Antonia Delgado. The couple had no children.
Bypass Pioneer
In 1962, Dr. Donald Effler invited Favoloro to come to the Cleveland Clinic to observe the work of the Department of Thoracic and Cardiovascular Surgery and serve as an apprentice to Dr. Delos M. Cosgrove, co-chair of the world-famous heart center there. He also studied with Mason Sones, considered to be the father of coronary cineangiography - the reading and interpreting of coronary and ventricular images.
Two other surgeons had already performed heart bypass surgery - Dr. David Sabiston at Duke University in 1962 and Dr. Edward Garrett, an associate of the renowned Dr. Michael DeBakey, in 1964. But both of these surgeries were done in response to deteriorating conditions while the patient was on the operating table, and neither procedure had been reported in a medical journal. Favaloro's heart bypass operation on a 51-year-old woman in 1967 was the first to be planned and reported in a medical journal. His technique was to stop the heart, take a section of vein from the patient's leg, sew one end into the aorta, and attach the other end to the blocked artery. It soon became a standard procedure that continued into the 21st century.
As Favaloro perfected the operation, it popularity spread. Within one year 171 bypasses had been performed at the Cleveland Clinic. Nagourney quoted a friend of Favaloro, Dr. Robert H. Jones of Duke University, who noted that Favaloro was "really the person who should get credit for introducing coronary bypass into the clinical arena." In the past, various methods had been attempted to treat persons with heart disease, but none had succeeded as well as Favaloro's surgical method.
Lifetime of Service
In 1971, Favaloro left Cleveland to return to Argentina, giving up a lucrative career to serve the people of his homeland. There he began to raise funds for a $55 million heart clinic he planned to build. In 1975 he established his foundation for that same purpose. By 1980 he was able to establish a center for cardiovascular surgery, training surgeons and cardiologists in his methods and ideas. The medical center and teaching unit were located in the Guemes private hospital in Buenos Aires. The Society of Distributors of Newspapers and Magazines donated an eight-story building as a private research center. Favoloro's clinic was finally completed in 1992, and his Institute of Cardiology and Cardiovascular Surgery of the Favaloro Foundation had its own home. Favaloro continued as the institute's director.
Throughout his career of service Favaloro remained a world figure. He was an active member of numerous professional organizations in the United States, Latin America, Europe, and the world including the American College of Surgeons, the American Association for Thoracic Surgery, the American Medical Association, the International Society of Cardiothoracic Surgeons, the Pan American Medical Association, the Third World Academy of Sciences, and other organizations.
Favaloro had several dozen teaching assignments throughout the international medical world. As an author and editor he wrote several books and served on the editorial boards of the Spanish-language version of the Journal of the American Medical Association (JAMA), the International Journal of Cardiology, the Journal of Cardiac Surgery, and Clinical Cardiology. Favaloro was a prolific author, writing more than 350 scientific papers, and six books, including two that have been translated into English, Surgical Treatment of Coronary Arteriosclerosis, published in 1970, and The Challenging Dream of Heart Surgery: from The Pampas to Cleveland, published in 1992. The topics of his other books included his personal memoirs of life as a physician.
Favaloro did not limit himself to print media. He developed a television program called "The Great Medical Issues," offering medical information on prevention and treatment of diseases. The program won two awards in Argentina during the mid-1980s. Another television series he created included 24 programs focused on drugs and aimed at young people.
Criticized Economic Policies
Favaloro harbored some discontent at the state of medicine in Argentina, criticizing the social and moral costs of managed health care. In a letter to the editor of La Nacion, a Buenos Aires newspaper, he noted that his foundation was owed $18 million from hospitals and state-owned medical centers. Nagourney quoted Favaloro, weeks before his death, writing that "I am going through the saddest period of my life. In the most recent times, I have been turned into a beggar," referring to the increasingly difficult task of finding enough money to perform necessary medical care and surgeries, particularly for the poor.
In a paper Favaloro wrote and presented at Leiden University in the Netherlands in February 1997, and that was reprinted for Interscientia, Favaloro explained the nature of cardiosurgery and its advances but also took on the social meaning of such changes. Favaloro noted a direct corollary between socioeconomic status and heart diseases and focused on the widening gap between the rich and the poor in education and health care. He commented that "…we are without doubt submerged in a materialistic, hypocritical and dehumanized society that has been developing slowly but steadily and which appears to have no limits to its appetites. All means are justified to increase power and pleasure through economic gains. It is of no importance that the greatest part of the population is excluded and survive in misery and lack of welfare." Favaloro was not referring only to Latin America or to Third World nations. He noted problems in getting adequate health care even in the United States. In his closing remarks, Favaloro said, "I did not present you with an indisputable truth. It would be a disgrace to say I am the owner of the truth. I would be gratified if my words only raised some doubts in your minds."
A National Hero
On July 29, 2000, Favaloro shot himself to death at his home in Buenos Aires. Argentina grieved at the loss of a national hero. According to Geoff Olson, writing for the Vancouver Courier an article in La Nacion "described his death as one more blow to 'the sad land of psychoanalysis and tango.'" Olson also referred to the national money crisis that had plagued Argentina for many years, which some observers blamed on privatization and a global economy that brought lower wages and dire financial conditions for workers. The fiscal downturn meant cutbacks in government funding for Favaloro's foundation. Also, according to Olson, "Two weeks before his death, in a memo to his staff, he excoriated economic globalization, stating that free-market reforms are 'better referred to as a neo-feudalism that is bringing this world toward a social disaster where the rich are getting richer and the poor are getting poorer.'"
Whether Favaloro's suicide was a deliberate statement against the state of the world in which he had to beg for money to cure people, or whether it was simply the act of someone desperately sad, can never be known. What is certain is that Favaloro left behind him a legacy of passion and dedication to serving the human race.
Periodicals
Heart Wire, August 11, 2000.
Interscientia, July 1997.
New York Times, August 1, 2000.
People's Union for Civil Liberties Bulletin (Delhi, India), October 2000.
Perteneser (Argentina), July 2000.
Texas Heart Institute Journal, 2000.
Vancouver Courier, February 11, 2002.
Online
"Altruism," George Mason University Objectivist Club,http://129.174.139.240/gmuoc/mt/archives/000071.html (December 31, 2003).
"Dr. Rene Favaloro," Favaloro Foundation,http://www.fundacionfavaloro.org (December 31, 2003).
"Dr. Rene Favaloro, Prince Mahidol Awardee," Prince Mahidol Award Foundation,http://kanchanapisek.or.th (December 31, 2003).
"Rene G. Favaloro? A great man and a great ideal," Sociedade Brasileira de Cardiologia (Brazilian Society of Cardiologists),http://publicaoes.cardiol.br (December 31, 2003).
"The Right to Health: Is it at Risk?" Canadian Conference on International Health,http://www.csih.org (October 28, 2003).
